WA to forgo the IT big bang in favour of incremental approach

Written by Kate McDonald on 20 May 2015.

Western Australia's Department of Health will concentrate on stabilising existing ICT infrastructure and implementing current systems in new facilities over the next three years following the endorsement of its recently released ICT strategy in last week's state budget.

The budget offered little in the way of funding for new ICT projects, with Treasurer Mike Nahan announcing a relatively small $103 million increase in total health funding in 2015-16.

However, Dr Nahan pointed to WA's massive investment in new health infrastructure over the last seven or so years, including the $2 billion Fiona Stanley Hospital (FSH), the new Perth Children’s Hospital due to open next year at a cost of $1.2 billion, and the new Midland Health Campus, a public-private partnership due to open in November at a cost of $360 million.

The 2015-16 budget papers detail money already allocated to ICT systems such as the new EMR promised for the Perth Children's Hospital (PCH) and the delivery of ICT systems at FSH and the Busselton Health Campus, but otherwise simply state that the government was endorsing the WA Health ICT Strategy 2015-2018.

This strategy outlines a decision-making framework for ICT across WA Health and sets out the key ICT priorities for the next three years, focusing on what it calls “incremental and affordable change to bring current systems up to date, deliver on existing projects, and build the foundations for the future”.

The strategy is deliberately short term and will avoid the big-bang approach that saw WA Health run into difficulties with the opening of FSH, which was delayed for six months due to the complexity of the ICT.

The hospital was expected to open with a big name electronic medical record but instead has opted for the BOSSnet digital medical record system with paper scanning and electronic forms from Core Medical Solutions.

According to the strategy, BOSSnet will be rolled out at other hospitals, including PCH and Busselton Health Campus. Midland Health Campus, which is being built in association with St John of God Health Care to replace the Swan District Hospital, is implementing Emerging Systems' EHS as part of its roll-out in St John of God facilities throughout the country.

CSC's iClinical Manager (iCM) will continue to be supported in a number of WA hospitals. Those sites not using iCM will be able to have access to metropolitan hospital reports, results and discharge summaries through the cView view-only web application on their mobile devices.

All hospitals are set to receive CSC's WebPAS patient administration system. WebPAS is used in a number of hospitals already, including FSH, Fremantle, Princess Margaret and Swan District Hospital.

“Introducing a common patient administration system will help standardise business processes and produce consistent information,” the strategy states. “Clinicians will be able to access information on a patient from any site. Reducing duplication will also improve patient safety outcomes. As a single billing system, it will also improve revenue collection and deliver cost savings.”

The strategy sets out five priority areas over three years, including stabilising existing ICT infrastructure, implementing ICT systems at new facilities, consolidating duplicate systems and building “the foundations for the future”. It also prioritises improving information management, including secure sharing of patient information in order to improve patient safety, quality of care and care coordination, and governance and clinical leadership.

“This is a short-term strategy specifically designed to help us stabilise our existing systems, bring our infrastructure up to a minimum standard, improve the way we share information and build a strong foundation for the future,” it says.

“It provides the framework for ICT decision making but does not dictate the systems and applications we will use or how ICT will be delivered. This means that we can remain agile and flexible and take advantage of available new technologies.

“Immediate action needed to address current system issues is defined in this strategy and will be delivered between 2015 and 2018.”

Year one of the strategy will including upgrading the standard operating system across WA Health to Windows 7 and completing the already agreed ICT systems at FSH, PCH, Midland and Busselton.

It will also see WA Health develop an applications roadmap, including developing options to roll out core clinical applications across the system, deploy key local applications, improve corporate systems and bring all sites up to a consistent standard.

All outstanding ICT requests will be reviewed and prioritised, and work will begin on establishing an enterprise architecture.

Years two to three will see WA Health develop a plan for an asset refresh, including the management of systems nearing their end date and legacy and unsupported applications.

“This plan will include a focus on the consolidation of multiple systems that perform the same function,” the strategy says. It will also see the completion of the implementation of ICT systems at Karratha Nickol Bay Hospital, and a commitment to explore the latest off-the-shelf health technologies and identify opportunities for their use in WA Health.

In terms of information sharing and management, the plan is to work with the National E-Health Transition Authority (NeHTA) to implement eHealth initiatives such as a state-wide provider index, state-wide discharge summary, the Notifications and Clinical Summaries (NaCS) roll-out and the Australian Medications Terminology mapping of WA’s drug catalogue.

Years two and three will also see WA Health continue to work with the federal government and other states and territories on the integration of the PCEHR.